Archive for January 2017

Welcome to the January edition of Ask Dr. Emily?

We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Rastall, a clinical psychologist at Seattle Children’s Autism Center, will share insights in a question and answer format. We welcome you to send us your questions and Dr. Rastall will do her best to answer them each month.

Q: My 3-year-old son just got a provisional autism diagnosis. I think he is able to “lie” to me. For example, after I put him in his crib he told me he needed to use the bathroom. So I brought him to the bathroom, but he refused to go. All the while, he was smiling and singing and excited to be out of the crib. Another time, he pretended to cough (while smiling) so that I would give him cough syrup (he loves the taste). Is this “lying?” Is it premeditated? What is going on here?

A: This sounds like pretty typical “kid” behavior. Most kids will try about anything to get what they want and/or like. Sometimes that means saying things that aren’t true to get their needs met. They are not meaning to deceive, but rather, they have learned that a certain behavior offers a certain result. Thus, they try the behavior again to see if it will pay off. Let’s say a child in the crib really does need to use the bathroom one night, and while doing so realizes, “Hey, I’m out of my crib!” They are more likely to ask to use the bathroom the next night as a way to get out of the crib.

Here’s another example: A child gets a fever and receives medicine and extra attention, gets to stay home from school, and gets to watch cartoons all day. They may try to convince you later that they are sick in hopes that they might get the same attention and privileges they received before. Who can blame them? I think we can all agree, this is less premeditative than simply reinforced, or learned behavior.

The best thing you can do in these situations is to give as little attention to the behavior as possible. You’ll want to do your own fact-checking and then respond as needed. Redirect and distract to move on to the next thing as soon as possible. Good luck, detective!

Please join us this Thursday, January 26, from 7 to 8:30 p.m. at Seattle Children’s Hospital for our free quarterly lecture, Autism 101. Autism 101 is intended for parents and families of children recently diagnosed with an autism spectrum disorder (ASD). In this free lecture, participants will learn about:

These classes are designed for parents, teachers and caregivers. The topics associated with the majority of classes are applicable to all age ranges and for a wide variety of children diagnosed with autism.

Considerable advances have occurred in both science and in the community, state and national levels in 2016. Seattle Children’s Autism Center’s Dr. Raphael Bernier, clinical director, and Jim Mancini, coordinator of training, education and outreach, will review the most newsworthy and influential scientific and community advances in the world of autism spectrum disorder from the past year. We will also discuss what we can expect in the changing educational and political landscape of 2017.

Highlights from Beautiful Minds Wasted, The Economist

Thanks to my colleague, Jennifer Mannheim, ARNP , for passing along a recent article on autism and employment (The Economist, April 16, 2016 Beautiful Minds Wasted). As more and more children with autism become young adults, it offers a look at what happens after educational services end.

This article provides a global glimpse at the state of employment for those on the spectrum and is chock-full of sobering statistics:

In 1970, 1 in 14, 000 children in the US were diagnosed with an ASD.

In 2016, 1 in 68 children in the US were diagnosed with an ASD.

In France, 90% of children with an ASD attend primary school but only 1% makes it to high school.

In the US, less than 50% of students with an ASD graduate from high school.

In the UK, 60% of teachers said they were unprepared to teach children with an ASD.

In the UK, 12% of adults with HFA are employed and 2% of adults with “more challenging forms of ASD”.

Globally, per the UN, 80% of adults on the spectrum are unemployed.

In the US, 19% of adults with an ASD in their early 20s live independently away from their parents.

1 in 4 adults with an ASD report feeling isolated (have not seen friends or received a social invitation in the past year).

The article identified some of the employment challenges for those on the spectrum, including difficulty with the social aspects of the interview process, the often over stimulating work environment and adapting to changes in schedules and routines. On the other hand, strengths of some on the spectrum include intense focus and an eye for detail, enjoyment of repetitive tasks, dependability in following rules and routines.

Also mentioned were employers throughout the world who have made efforts to assist employees with an ASD to be successful including Specialisterne, A Danish firm that offers training and help finding jobs, Kaien in Japan, AQA in Israel, Passwerk in Belgium, and Walgreens in the US.

The Economist cites lifetime cost of unemployment associated with an ASD (lifelong care, lack of output by such individuals and un/under employment by families who care for those who do not work) is cited as between 1.4-2.4 million dollars.

Depressing? Yes. Surprising? No. The world is still not capably or comprehensively providing services and supports for children with an ASD and their families. It is only beginning to see the massive wave of children now coming of age into adulthood. Our kids are not ready for the real world and the real world is not ready for them.

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